Ripening Agents Research Articles

Efficacy and Safety of Oral Mifepristone as a Cervical Ripening Agent for Labor Induction in Low-Risk Full-Term Live Pregnancies Beyond 40 Weeks of Gestation: A Randomized Controlled Study

Efficacy and Safety of Oral Mifepristone as a Cervical Ripening Agent for Labor Induction in Low-Risk Full-Term Live Pregnancies Beyond 40 Weeks of Gestation: A Randomized Controlled Study

Post-harvest Treatment of Banana with Artificial Ripening Agent Influences Its Nutritional Quality and Antioxidant Potential

Bananas are widely consumed fruits that are often subjected to artificial ripening to accelerate their marketability for economic gains. Calcium carbide (CaC2) is most commonly used as ripening agent, particularly in developing countries, due to its low cost and effectiveness. However, the use of CaC2 has raised concerns about its potential impact on the safety and nutritional quality of the treated fruits. Assessment of the impact of this practice on the nutritional value of banana is key to improving its functionality and maximize its nutriture. This study was undertaken to examine the effect of post-harvest treatment of banana with calcium carbide agent on nutrient composition and antioxidant enzymes of the pulp. Mature green bananas were separated into fingers of the same size and divided into 4 groups. Group I was untreated and unripen while groups II and III were CaC2-treated at 4g/kg and 8g/kg of fruit respectively. Group IV underwent natural ripening. Proximate composition, sensory evaluation and antioxidant enzyme analyses were carried on the samples after the treatment period following standard procedures. The results show that calcium carbide used at 4g/kg and 8g/kg tilted sensory properties of banana pulp towards low values but not significantly (p > 0.05). On the other hand, there was significant difference (p < 0.05) in the proximate composition of the artificially ripened banana compared to control bananas. Similarly, the levels of essential minerals decreased significantly (p < 0.05) in treated groups II and III compared with group 4. Furthermore, the results of antioxidant enzyme activities indicated that calcium carbide treatment compromised the levels of all the antioxidant enzymes analysed as their concentrations significantly decreased (P < 0.05) from 3.42 to 1.65 U/mL; 32.79 to 22.73 U/mL and 0.68 to 0.28 U/mL for peroxidase, ascorbate peroxidase and catalase respectively. These findings have shown how the nutritional composition as well as antioxidant potential of banana could be compromised if the use of chemical ripening agents such as calcium carbide continues unabated.

Combination Foley Catheter-Oxytocin versus Oxytocin Alone following Preterm Premature Rupture of Membranes.

The benefit of mechanical ripening agents following preterm premature rupture of membranes (PPROM) has not been established. We sought to compare the time to delivery in women who received transcervical Foley catheter plus oxytocin infusion versus oxytocin infusion alone in patients with unfavorable cervices and PPROM. This is a retrospective cohort study of patients presenting with PPROM of a live, singleton gestation between 240/7 and 366/7 weeks' gestation from January 2005 to October 2018 at a single, tertiary care institution. Patients with an unfavorable cervical examination (≤2-cm dilation), no contraindication to labor and undergoing labor induction were analyzed. Time to delivery was analyzed using multivariable linear regression adjusting for cervical dilation at induction and nulliparity. Bivariate and multivariate analyses were used where appropriate. A total of 260 participants were included: 109 who received a Foley catheter and oxytocin (Foley/oxytocin) and 151 who had oxytocin alone. Demographic characteristics were similar between the two groups. Unadjusted time to delivery was significantly shorter in the oxytocin only group (Foley/oxytocin: 20.35 hours vs. oxytocin alone: 14.7 hours, p < 0.001). No differences in length of labor were detected after adjusting for cervical dilation at induction and nulliparity (p = 0.5). The unadjusted rate of cesarean delivery was higher in the combination Foley/oxytocin group (Foley/oxytocin: 16.5% vs. oxytocin alone: 7.3%, p = 0.03), but no differences were found in the adjusted analysis (p = 0.06). There were no differences in clinical chorioamnionitis rates between the two groups (Foley/oxytocin: 8.3% vs. oxytocin alone: 9.3%, p = 0.83). Furthermore, no significant differences were found in maternal and neonatal outcomes between the two groups. In patients with PROM, the use of a transcervical Foley catheter in addition to oxytocin is not associated with a shorter time to delivery compared with oxytocin alone. · Transcervical Foley catheter did not shorten length of labor in PPROM.. · Transcervical Foley catheter did not increase infection risk.. · Pitocin alone can be used in PPROM population..

Study of food toxicology of toxins artificially introduced into the food or fruits.

A recent incidence reported in NEWS media of artificial fruits ripening agent's toxic to health and killed several seasonal fruit eaters because of the toxicity of the fruit introduced with such toxic ripening agents that affect adversely on health of humans and animals both consumers equivalently have been highlighted in this study.

Fetal heart rate patterns and the incidence of adverse events after oral misoprostol administration for cervical ripening among low-risk pregnancies

Objective Though misoprostol is commonly used for inpatient cervical ripening, its use in outpatient settings has been limited by safety concerns. This study was conducted to assess the association between early fetal heart tracing (FHT) and maternal tocodynamometry patterns and the incidence of adverse fetal and pregnancy outcomes after the administration of oral misoprostol for cervical ripening. Methods We conducted a retrospective cohort study of 9908 low-risk patients at ≥37 weeks gestation who received oral misoprostol for cervical ripening prior to rupture of membranes between 01/01/2012 and 12/31/2017 at Kaiser Permanente Northern California hospitals as inpatients. We excluded patients who received a different agent for cervical ripening or had any need for additional inpatient monitoring, including hypertensive disorders of pregnancy, diabetes, or intrauterine growth restriction. Abnormal FHT, abnormal uterine activity, and adverse pregnancy or fetal-related events documented in the electronic health record in the four hours after administration of the first and second doses of misoprostol were assessed using descriptive statistics. Results We found that 0.9% of patients experienced tachysystole after the first dose of misoprostol (0.6% without decelerations; 0.3% with decelerations). The incidence of variable decelerations only and other FHT abnormalities (i.e. bradycardia, late or prolonged decelerations, or absent or minimal variability) in the first hour after misoprostol administration were 7.1% and 6.7% respectively, and diminished over time. The need for tocolytic use was 0.2% in the first hour and declined over time to 0.03% in the fourth hour after the first dose. Urgent cesarean delivery occurred in 0.1% of patients after receiving the first dose of misoprostol. Patients who did not experience variable, prolonged, or late decelerations in the first hour after the initial misoprostol dose were less likely to have such FHT abnormalities in the subsequent three hours compared to patients who had other FHT abnormalities (11.8% among patients with no FHT abnormalities vs. 43.7% among patients with other FHT abnormalities; p <.001). The overall trends in outcomes over time were similar after the second dose of misoprostol. Conclusion The risk of short-term adverse outcomes associated with misoprostol is low among relatively low-risk patients. FHT abnormalities occurred in up to 32% of patients in the first four hours of monitoring post-misoprostol. Patients with no FHT abnormalities in the first hour after receiving misoprostol had a low risk of developing adverse outcomes and FHT abnormalities on continued monitoring, while patients with any type of deceleration in the first hour were at higher risk of adverse outcomes and FHT abnormalities. Our data may inform the development of protocols for cervical ripening that allow reduced monitoring for a subset of low-risk patients, however, more research is needed to validate findings and develop clinical protocols.

Determination of Heavy Metals Recovered from Artificially Ripe Banana with Calcium Carbide

Calcium carbide is frequently used by vendors to hasten the ripening of banana fruits, and this practice has a long history. Calcium carbide is connected to the negative consequences of heavy metals. Measurements of heavy metal concentrations on artificially ripe bananas using calcium carbide in Katsina state and throughout Nigeria are essential to assist the competent authorities in regulating the use of chemical ripening agents for food safety and consumption. This study aims to assess the levels of heavy metals in banana fruits that have been artificially made to ripen. A sample was collected from Mairuwa Fadama of Katsina state's Funtua local government Area. The Banana pulp and peel were analyzed for heavy metals (arsenic, calcium, lead and cadmium) content using standard methods. Results showed that heavy metal concentrations in the banana peel are higher than in the banana pulp. The findings detail the heavy metals content of the banana peel and pulp eaten in Katsina State. The findings also showed that banana peels contain more heavy metals than pulp.

Efficacy of Prostaglandin Analogues for Induction of Labour and Associated Complications: A Retrospective Research Study conducted in Latifa Women and Children Hospital

Induction of labour has become a more common worldwide medical intervention during the last few years [1]. The ideal cervical ripening agent must be effective, safe, easy to be administered and acceptable for the pregnant woman. Utilizing prostaglandins (PG) for cervical ripening during induction of labour (IOL) was first described in the 1960s [2]. Since that time various types of prostaglandins including PGF2α, PGE2 (Dinoprostone) and PGE1 (Misoprostol) were extensively studied to elicit the best prostaglandin pharmacological agent for pre-induction cervical ripening [2]. Dinoprostone was found to be superior to the others, as it increased the rates of successful vaginal delivery within 24 h without increasing the operative delivery rates. Vaginal route was found to be a safe and effective approach of bringing on labor.

Effect of different ripening agents in storage life of banana (Musa paradisiaca) at Deukhuri, Dang, Nepal

An experiment was conducted at the horticulture laboratory of Prithu Technical College, Deukhuri, Dang, Nepal from 17th to September 30, 2021 to determine a suitable ripening agent for bananas. The experiment was set up in a Completely Randomized Block Design (CRD) consisting of one control and six ripening agents. The ripening agents include five organic ripening agents: ashuro 100 g (T2), dhurshilo 100 g (T3), apple 100 g (T4), tomato 70 g (T5), and paddy straw 100 g(T6), and one chemical ripening agent: ethephone 1000 ppm (T7), each replicated three times. A dozen of the hard green stage of G9 bananas were used for each treatment and kept in a separate Low-Density Polyethylene bag with two perforations. The treated bananas were tested for major physio-chemical changes (physiological weight loss, pulp/peel ratio, total soluble solid, specific gravity, titrable acidity, and firmness), color change of banana peel, and days to ripen. T7 and T4 had the shortest ripening period (3 and 4 days respectively) and shelf-life (3 and 4 days respectively) while T1 and T6 had the longest ripening period (11 and 9 days respectively) and shelf-life (8 days). At days to ripen, T7 and T4 had the least physiological weight loss (2.43 and 2.87% respectively) and highest Total Soluble Solid (13 and 13.23 ˚brix respectively). Thus, T7 proved better for quick ripening but is toxic in nature while T4, in comparison to T7, showed comparatively more shelf-life, similar ripening period, and more importantly, it is easily accessible and has no hazardous effect on health, so T4 can be regarded as the most effective agent for banana ripening. However, if bananas are to be stored for a longer time, T6 can be recommended. • Apple can be an effective ripening agent for bananas. • Chemical ripening agents are harmful to health. • Paddy straw can be used for the long storage life of banana. • Ripening agents can change the ripening period and storage life of bananas.

Environmental chemical risk factors of breast cancer in Nigeria III: Metal: Lead

Lead (Pb) is a metalloestrogen and a notable breast cancer risk factor. Lead is an International Agency for Research on Cancer (IARC) group 2A carcinogen. There is no level of exposure to lead that is known to be without harmful effects. Nigeria has literally every known environmental risk factor for lead exposure. Notable sources of lead exposure in Nigeria are lead in contaminated water, paints, artisanal gold ore processing, incineration of lead-containing waste and electronic waste (e-waste). Other sources of lead exposure are ‘tiro’—a lead-laden eye cosmetic, smoked fish particularly those displayed near highways with high vehicular traffic density, vegetables and root crops grown in mining communities, fruit exposed to lead-laden ripening agents, “Calabar chalk”—a lead-laden pica mostly consumed by pregnant women, and children’s toys. Prenatal vitamins supplements, paediatric medication syrups, traditional alcoholic and non-alcoholic drinks such as Kunnu and Zobo were also found as notable sources of lead consumption. Studies in Nigeria on blood lead (Pb) levels in children, pregnant women, and breast milk of nursing women were found to contain high lead levels. Lead exposure is preventable. Hitherto, the neurotoxicity of lead has been the dominant concern as regards lead exposure in children. The breast cancer risk factor now reinforces the zero tolerance for lead exposure.

The Physical and Sensory Qualities of ‘Lakatan’ Banana (Musa acuminata) in Response to Different Natural Ripening Agents

‘Lakatan’ banana is amongst the most important banana varieties in the Philippines. This variety of bananas is widely known and cultivated due to its good sensory qualities and potential for the export market. Locally, ‘Lakatan’ banana is ripened by retailers through the use of calcium carbide and/or ethephon. However, these ethylene-producing chemicals were reported to cause poisoning and alter the fruit's taste. This study is designed to investigate the effects of natural ripening agents such as plant leaves on the ripening qualities and sensory attributes of ‘Lakatan’ banana under room conditions. The result results revealed that C. muconoides and F. septica significantly induced faster ripening of banana as compared to other treatments. Additionally, the disease severity of ‘Lakatan’ banana was lower in both leaves as compared to other treatments. On the other hand, bananas treated with C. muconoides, F. septica, and A. carambola leaves were found to have a longer marketable days. In terms of sensory quality, fruits treated with C. mucunoides, G. sepium, and A. carambola leaves were found to have high sensory acceptability. The results have concluded that leaves of C. muconoides, F. septica, G. sepium and A. carambola have great potential in ripening climacteric fruits like bananas, and these leaves are good substitutes for chemical ripening agents. The research highlights the need for further studies on the biological sources of ethylene to understand its advantages, including its limitations.

ASSESSMENT OF THE BIOCHEMICAL PARAMETERS ON THE FIRST FILIAL GENERATION FROM THE WISTAR RATS FED WITH CALCIUM CARBIDE RIPENED ORANGE.

Purpose and Methods: The use of chemicals for fruit ripening is constantly on the increase and inadvertently, such chemicals are consumed unperceived. The aim of the study is the assess the Biochemical parameters of the Pups from the Wistar rats fed with Calcium Carbide induced ripened orange. Unripe mature oranges were gotten for the parent plant at Ogu, Yenagoa, Bayelsa State. The fruits were divided into two; the first group was allowed to ripe at normal room temperature and 1kg of the second oranges wrapped with black nylon were forced to ripe within 48 hours with 10grams of Calcium carbide which was dissolved in 5ml of water in a closed steel bucket. 600g of each groups of the ripened oranges were peeled differently and blended in an electric blender with 350ml/1L distilled water. The juice was filtered with a clean fine sieve and were poured into clean bottles labeled accordingly and stored in a refrigerator for future use. 24 adult Wistar rats [12 male and female of each sex] weighing between 126.9- 213.3g were used. They were acclimatize for two [2] weeks and was fed with standard grower mash with clean water ad libitum. The Wistar rats were grouped into three, [1] Control, of 8 rats [4 males and 4 females] receive normal water and feeds only as placebo. [2] Treatment group I, containing 8 rats [4 males and 4 females] received 5ml/kg of the naturally ripened orange juice [3] Treatment II of 8 rats [4 males and 4 females] received 5ml/kg of the Calcium carbide induced ripened orange juice orally against their body weight for four weeks. The Wistar rats copulates freely during this period. Birthing occurred in the three groups and the Pups were collected weight at birth, at one week and the two week. They were sacrifice at second week and blood sample collected for the Biochemical analysis. Data collected from this study was analyzed as Mean ± Standard Error of Mean [SEM]. Significant difference among the groups was determined as P&lt;0.05; by two-way ANOVA; using Statistical Analysis Program for Social Sciences [SPSS 22.0 Version].&#x0D; Findings and recommendations: The results of this study showed statistically significant increase in the mean AST, ALT, ALP, Creatinine, Urea, Total Biluribin and Lactate Dehydrogenase of the pup of the Wistar rats fed with Calcium carbide forced ripened orange juice in contrast with the control group (p&lt;0.05). There was significant reduction in the mean Albumin, Total Protein and Total Cholesterol in the pups from the Wistar rats fed with Calcium carbide forced ripened orange juice when compared with the control group (p&lt;0.05). In conclusion, there is nutritional programming of Calcium Carbide forced ripened fruit when consumed by a mother and could cause hepatic and/or extra-hepatic toxicity, renal failure, heart failure, coronary heart diseases of the offspring. Thus; we recommend strongly, the abolishment of Calcium carbide as an agent for fruit ripening.

A prospective study to compare oral mifepristone and dinoprostone gel in induction of labour in primigravida

Induction of labour is defined as the process of artificially stimulating the uterus to start labour. Mifepristone is a synthetic steroid hormone analogue that has both antiprogesterone and antiglucocorticoid activities. It increases the sensitivity of the uterus to prostaglandins and facilitates labour. 2 Dinoprostone, is a naturally occurring prostagladin that is involved in promoting labour. The aim of this study was to compare the safety and efficacy of oral mifepristone with dinoprostone gel in induction of labour in primigravidas. To compare the safety and efficacy of oral mifepristone with dinoprostone gel in induction of labour at term. This was a hospital based prospective study conducted from August 2019 to January 2021.Group 1 involved primigravida who were given oral 200mg Mifepristone on an inpatient and primigravida in Group II were instilled with Dinoprostone gel 0.5mg without mifepristone ripening and further assessment were done in both groups. Progress of labour was seen and further augmentation done with oxytocin whenever required. Majority of the patients were between 39-41 weeks which shows almost equal distribution in both the group. It was observed that there was significant improvement in the Bishop’s score after administrating Mifepristone to the patients which was proved statistically significant (&amp;#60;0.004). Most of the patients delivered vaginally and was observed that there was 28% reduction in LSCS in Group I which was highly significant with p value &amp;#60; 0.004. We concluded that Mifepristone is a safe and efficient agent for cervical ripening and for initiation of labour in term patients as it causes improvement in bishops score and increase in vaginal delivery.

Study on the Application of Electronic Nose Technology in the Detection for the Artificial Ripening of Crab Apples

Ripening agents can accelerate the ripening of fruits and maintain a similar appearance to naturally ripe fruits, but the fruit flavor and quality will be changed compared to naturally ripe fruits. To find an efficient detection method to distinguish whether crab apples were artificial ripened, the naturally ripe and artificially ripe fruits were detected and analyzed using the electronic nose (e-nose) technique in this study. The fruit quality indexes of samples were determined by the traditional method as a reference. Significant differences were found between naturally ripe and artificially ripe fruits based on the analysis of soluble sugar content, titratable acidity content, sugar–acid ratio, soluble protein content, and soluble solids content. In addition, principal component analysis (PCA), linear discriminant analysis (LDA), support vector machine (SVM), and random forest (RF) analyses were performed on the electrical signals generated by the electronic nose sensor, respectively. The results showed that the RF is the best recognition algorithm for distinguishing which crab apples were naturally ripe or artificially ripe; the average recognition accuracy is 98.3%. On the other hand, the prediction models between the e-nose response data and fruit quality indexes were constructed by partial least squares regression (PLSR), which showed that the feature value of e-nose response curves extracted by wavelet transform was highly correlated with the quality indexes of fruits, the determination coefficients (R2) of regression models were higher than 0.91. The results demonstrated that the detection technology with an electronic nose could be used to test whether the fruit of the crab apple was artificially ripe, which is an economical and efficient method.

Role of Isosorbide Mononitrate as an Agent for Cervical Ripening in Second-trimester Abortions

Role of Isosorbide Mononitrate as an Agent for Cervical Ripening in Second-trimester Abortions

Human health risk assessment on the consumption of Musa acuminata treated with different ripening agents

Human health risk assessment on the consumption of Musa acuminata treated with different ripening agents

Elemental analysis of mango ripened by different postharvest treatments using laser induced breakdown spectroscopic

Laser induced breakdown spectroscopy (LIBS) provides sample information on elemental scale. Current result depicts both qualitative and quantitative detection of most prominent organic elements like hydrogen (H), nitrogen (N), oxygen (O) and carbon (C) from mango pulp ripened under different post- harvest treatments. Similarly, it also indicates variable concentration of minerals such as calcium (Ca), magnesium (Mg) and potassium (K) under these treatments. The concentration of Ca, Mg and K detected under different postharvest ripening techniques are 0.163−0.257 mg\\100 gm, 0.212−0.431 mg\\100 gm and 0.675−1.802 mg\\100 gm respectively. Moreover, the respective concentration H, N, O and C are 41.56−46.51 gm/100 gm, 41.28−44.91 gm\\100 gm, 12.11−14.49 gm\\100 gm and 53.1−100.1 mg\\100 gm. Traces of arsenic (As) or phosphorous (P) were not found in samples treated with calcium carbide. Further studies on commercial grade fruits ripened with these agents are required to differentiate among nutritional elements of mango fruits treated under different ripening agents as well as to confirm the presence/absence of health hazardous elements.

Effect of subacute oral exposure to calcium carbide (CaC2) on some haematobiochemical parameters in male Wistar rats

Introduction: One of the most common methods of forced ripening of fruits involves the use of calcium carbide (CaC2). Commercial grade CaC2 contains impurities with the potential to cause harmful effects to exposed individuals. This study was conducted to determine the effect of exposure to CaC2 on some haematological and biochemical parameters in rats. Methods: Adult male Wistar rats (n=20) were divided into four equal groups. Animals in Groups I (control), II, III and IV were respectively administered distilled water (2 mL/kg), 125, 250 and 500 mg/kg calcium carbide, orally, by gavage, before feeding, daily for 28 days. The erythrogram, leucogram and plasma total protein were determined, while changes in serum and brain biomarkers of oxidative stress (superoxide dismutase (SOD) activity and malondialdehyde (MDA) concentration) were assessed. Weight changes at the beginning and at the end of the exposure period (28 days) and signs of toxicity daily, were recorded. Results: The findings revealed significantly (p&lt;0.05) lowered levels of red blood cells count (RBC count), haemoglobin and total white blood cells count (TWBC) in the rats exposed to CaC2. How-ever, the packed cell volume (PCV) was not significantly (p&gt;0.05) lowered. Furthermore, there was an increase in MDA concentration but a decrease in SOD activity in the brain and serum of the experimental animals. Significance: Exposure to CaC2 induced adverse heamatobiochemical changes in rats which could signal danger to humans using this agent for fruit ripening.

Comparison of pigments and some physicochemical properties of banana as affected by ethephon and acetylene induced ripening

The study evaluates effects of selected two types of induced ripening agents; ethephon and acetylene on biochemical parameters of banana (Musa acuminata, AAB). Bananas at fully green stage were treated with 1000 ppm ethephon and 1000 ppm acetylene. A series of biochemical parameters including vitamin C, tannin, pectin and pigments (chlorophylls and carotenoids) were analyzed. It is revealed that fruit firmness, total sugar and vitamin C are greatly affected by ethephon and acetylene treatments whereas ethephon causes nearly 50% loss of vitamin C at eat ripe stage (Stage 6). Out of the parameters tested peel colour, pulp to peel ratio, moisture content in peel, titratable acidity (TA) % and total starch in flesh were not significantly (p > 0.05) affected by the treatments. Acetylene treatment caused significantly (p > 0.05) low level of moisture content in flesh, high level of tannin and pectin at stage 6. Treated banana contained high levels of chlorophyll a and chlorophyll b whereas significantly low levels of total carotenoids were detected in both peel and flesh in treated banana.

Ripening quality of banana cv. Amritasagor through application of different ripening agents

Desirable ripened quality banana fruits are important for the consumer acceptability. Banana cv. Amritasagar was treated with different ripening agents like control (R1), RipestuffTM @ 42 mg/10 mL water (R2), RipestuffTM @ 84 mg/10 mL water (R3), Ethephone @ 200 ppm (R4) and Ethephone @ 400 ppm (R5); and storage durations were 24 h (H1), 48 h (H2), 72 h (H3), and 96 h (H4). The two factors experiment was conducted with complete randomized design with three replications. Fruits were placed in container (RFL). With the progress of storage duration quality parameters like weight loss (%), peel color, pulp to peel ratio, softness, total soluble solids (TSS), and pH were recorded. Fruits treated with R3 and R5 produced uniform yellow color and the highest softness at 96 h. Whereas banana fruits treated with R2 developed peel colour and softness a bit slower compared to other treatments; and untreated fruits (control) were hard, poor in color and quality, and were not suitable for consumption at 96 h. The highest TSS (%) were found at 72 h treated with R5 and at 96 h with R5 including R3, and R4 showed the mostly similar TSS (%). Thus, RipestuffTM @ 84 mg/10 mL water (R3) and ethephon @ 400 ppm (R5) can be used maintaining quality and ripening banana for better price of banana growers and traders through avail it at earlier marketing and reduced postharvest loss.

133 Association between simplified bishop score after cervical ripening and delivery outcome

A favorable Simplified Bishop Score (SBS>5) before induction of labor is associated with successful vaginal delivery. Unfavorable cervices (SBS≤5) undergo cervical ripening prior to administration of oxytocin. However, data is limited regarding the utility of the SBS after cervical ripening. The objective of this study is to determine if SBS prior to oxytocin induction, but after cervical ripening, is associated with vaginal birth. We conducted a retrospective cohort study on patients undergoing induction of labor from the NICHD Consortium on Safe Labor. Singleton term pregnancies who initially received cervical ripening agents were included. Patients with a history of cesarean were excluded. An SBS>5 after cervical ripening was compared to SBS≤5. Primary outcome was mode of delivery. Multivariate logistic regression was performed to control for variables, including admission SBS and parity. A total of 5,807 patients met criteria to be included in the study. 4,235 (73%) patients had an SBS≤5 and 1,572 (27%) patients had an SBS>5 after cervical ripening. The SBS≤5 group had more cesarean deliveries (32% vs 11%, p<0.0001). Both groups had low rates of maternal chorioamnionitis (4% vs 2%, p<0.0001). There was no significant difference in rates of postpartum hemorrhage, NICU admission, or birthweight. More cesarean deliveries among the SBS≤5 group persisted when stratifying by parity (nulliparous: 44% vs 18%; multiparous: 12% vs 2%, both p<0.0001). After controlling for maternal age, pre-pregnancy BMI, parity, gestational age, and SBS at admission, SBS≤5 remained significantly associated with more cesarean deliveries (aOR=2.52, 95% CI 1.98, 3.22). Starting oxytocin with SBS>5 after cervical ripening is associated with successful vaginal birth, even after adjusting for parity and admission SBS. Consideration of SBS after cervical ripening should be given prior to induction with oxytocin. However, further research is necessary to determine the ideal endpoint of cervical ripening.View Large Image Figure ViewerDownload Hi-res image Download (PPT)